title: Success rates of trabeculotomy for steroid-induced glaucoma: a comparative, multicenter, retrospective cohort study.
abstract: OBJECTIVE
  To evaluate the surgical outcomes of trabeculotomy for steroid-induced glaucoma.
  
  
  METHODS
  Multicenter, retrospective cohort study.
  
  
  METHODS
  At 17 Japanese clinical centers, 121 steroid-induced glaucoma patients who underwent trabeculotomy between 1997 and 2006 were reviewed. Surgical failure was defined by the need for additional glaucoma surgery, deterioration of visual acuity to no light perception, or intraocular pressure ≥21 mm Hg (criterion A) and ≥18 mm Hg (criterion B). Surgical outcomes were compared with those of 108 primary open-angle glaucoma (POAG) patients who underwent trabeculotomy and 42 steroid-induced glaucoma patients who underwent trabeculectomy. Prognostic factors for failure were evaluated using the Cox proportional hazards model.
  
  
  RESULTS
  The probabilities of success at 3 years for trabeculotomy for steroid-induced glaucoma vs trabeculotomy for POAG was 78.1% vs 55.8% for criterion A (P = .0008) and 56.4% vs 30.6% for criterion B (P < .0001), respectively. At 3 years, the success of trabeculotomy for steroid-induced glaucoma was comparable to trabeculectomy for steroid-induced glaucoma for criterion A (83.8%; P = .3636), but lower for criterion B (71.6%; P = .0352). Prognostic factors for failure of trabeculotomy for steroid-induced glaucoma were previous vitrectomy (relative risk [RR] = 5.340; P = .0452 on criterion A, RR = 3.898; P = .0360 for criterion B) and corticosteroid administration other than ocular instillation (RR = 2.752; P = .0352 for criterion B).
  
  
  CONCLUSIONS
  Trabeculotomy is effective for controlling intraocular pressure <21 mm Hg in steroid-induced glaucoma eyes.
authors.affiliation: Department of Ophthalmology and Visual Science, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Kumamoto, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Iwao
authors.forename: Masaru
authors.initials: M
authors.lastname: Inatani
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Tanihara
mesh_terms: D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage; D015331:Cohort Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000139:chemically induced* / Q000503:physiopathology / Q000601:surgery*; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin; D011336:Probability; D012189:Retrospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000477:Alkylating Agents; D005938:Glucocorticoids; D016685:Mitomycin